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精神分裂症的神经心理学风险指标:对精神分裂症和双相情感障碍先证者女性亲属的初步研究。

Neuropsychological risk indicators for schizophrenia: a preliminary study of female relatives of schizophrenic and bipolar probands.

作者信息

Kremen W S, Faraone S V, Seidman L J, Pepple J R, Tsuang M T

机构信息

Department of Psychiatry, University of California, Davis School of Medicine, Sacramento 95817, USA.

出版信息

Psychiatry Res. 1998 Jul 13;79(3):227-40. doi: 10.1016/s0165-1781(98)00042-0.

Abstract

Evidence of subtle neuropsychological deficits in relatives of schizophrenic probands (REL-SZs) suggests that these are risk indicators for schizophrenia, but little is known about whether neuropsychological performance in REL-SZs differs from that in other groups of relatives. We compared neuropsychological function in female REL-SZs (n = 39), relatives of primarily psychotic bipolar disorder probands (REL-BPs; n = 15), and a normal control group (n = 44). After adjustment for expected intellectual ability (based on reading recognition), REL-SZs showed deficits in verbal and visual memory (Wechsler Memory Scale-Revised logical memories, visual reproductions), and auditory attention (dichotic digits) compared with either REL-BPs or control subjects. Memory, but not dichotic listening differences remained significant after adjusting for current IQ; however, average effect sizes after controlling for either reading or IQ were roughly comparable for these three parameters (d = 0.80, 0.71, and 0.69, respectively). REL-BPs and control subjects showed little difference. Although both schizophrenic and bipolar patients often manifest neuropsychological dysfunction, these preliminary findings indicate subtle neuropsychological deficits only in REL-SZs. Such differences suggest different underlying processes; neuropsychological impairment may, in part, reflect an expression of genetic liability to schizophrenia but not bipolar disorder. Replication with a larger REL-BP sample and with male relatives is needed to evaluate the generalizability of the results.

摘要

精神分裂症先证者的亲属(REL-SZs)存在轻微神经心理学缺陷的证据表明,这些是精神分裂症的风险指标,但对于REL-SZs的神经心理学表现是否与其他亲属组不同,人们知之甚少。我们比较了女性REL-SZs(n = 39)、主要为精神病性双相情感障碍先证者的亲属(REL-BPs;n = 15)和正常对照组(n = 44)的神经心理学功能。在根据阅读识别能力调整预期智力后,与REL-BPs或对照组相比,REL-SZs在言语和视觉记忆(韦氏记忆量表修订版逻辑记忆、视觉再现)以及听觉注意力(双耳分听数字)方面存在缺陷。在调整当前智商后,记忆缺陷仍然显著,但双耳分听差异不再显著;然而,在控制阅读或智商后,这三个参数的平均效应大小大致相当(分别为d = 0.80、0.71和0.69)。REL-BPs和对照组之间差异不大。虽然精神分裂症患者和双相情感障碍患者都经常表现出神经心理学功能障碍,但这些初步发现表明只有REL-SZs存在轻微神经心理学缺陷。这些差异表明存在不同的潜在过程;神经心理学损害可能部分反映了精神分裂症而非双相情感障碍的遗传易感性表达。需要用更大的REL-BP样本和男性亲属进行重复研究,以评估结果的普遍性。

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